Organization
DENTRUST DENTAL SOUTH CAROLINA PC
Active
Other names
DOCS Dental Ft.Jackson
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA CLARK (DIRECTOR OF CREDENTIALING)
(267) 927-5000
Entity
Organization
Contact information
Practice address
4712 LIBERTY DIVISION AVE, COLUMBIA, SC 29207-5405
(803) 334-0530
Mailing address
1221 VINEWOOD DR, SEFFNER, FL 33584-4829
(813) 451-4503
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
06/18/2024
Last updated
06/18/2024
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